Case 1

A 78-year-old female comes to your office escorted by a neighbor who is a patient of yours. The neighbor, who has lived next door to the older woman for years, relates that a week ago the elderly woman’s sister died and that she had been her caregiver for many years. The neighbor relates that although she would occasionally see the older woman, she did not visit the home. At the funeral last week, she noticed that the woman appeared fatigued, confused, sad, and gaunt in appearance. Later the neighbor approached the woman, inquired about her health, and determined that the woman had a very difficult time the past couple of months, caring alone for her sister until the end when hospice care was initiated. The neighbor convinced the woman to seek medical care and today is the first appointment with a provider that this 78-year-old female has had in 3 years. The older woman states that she is very fatigued and sad over the loss of her sister. Neither her sister nor the patient has been married. A distant niece came to the funeral but lives about 30 miles away. The woman states that she is not taking any prescription medication and relates no medical problems that she is aware of being diagnosed.

Vital signs: T 97.6°F, HR 98, RR 22, BP 95/60, BMI 21 

Chief Complaint: Fatigue and sadness over the death of her older sister.

Discuss the following:

1) What additional subjective information will you be asking the patient?
2) What additional objective findings would you be examining the patient for?
3) What are the differential diagnoses that you are considering?
4) What laboratory tests will help you rule out some of the differential diagnoses?
5) What screening tools will you select to use on this patient?
6) What is your plan of care?
7) What additional patient teaching may be needed?
8) Will you be looking for a consult?

Submission Instructions:

  • Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.

PHE5015 – Week 2 Project

Instructions attached

Discussion Topic: Discussion: When Ethics Conflict

 

Purpose

This assignment is intended to help you learn to do the following:

  • Describe ethical considerations for healthcare professionals and medical researchers.
  • Apply ethical decision-making models to healthcare ethical dilemmas.
  • Evaluate legal issues in healthcare decision-making situations.

Action Items

  1. Read Ethics case: Should One Kind of Freedom Be Restricted to Promote Another?Links to an external site.
  2. Respond in a 150- to 200-word discussion post to the following prompts:
    • What are the ethical issues addressed in this case?
    • Which issues are ethics issues and which are medical decisions? Explain your answer.
    • Who needs to be involved in making the necessary decisions to move forward?
    • Answer the key questions posed in the article, “What factors can make the clinical benefits of restraints outweigh their harms, and how can restraints be effectively and ethically regulated and applied?” Explain your answer.
  3. By the due date indicated, create your initial post.
  4. By Sunday, respond to at least two of your classmates. Your response should be thoughtful and add to the learning.

Mod.2IN TABLE-APA STYLE/Turnitin-Plagiarism FREE

Agency Synopsis

Identify regulatory agencies that regulate health and the health care system within the US, create a table (TEMPLET TO USE INCLUDED) listing your 5 regulatory agencies and address the following:

  1. Describe the agency, level of regulatory authority (local, state, federal), scope of regulatory authority, and role within the US healthcare system.
  2. Address relevance of the organization or the organization’s authority to the APRN/DNP graduate.
  3. Describe relevance to specialty area, area of practice, or setting of practice. For an example, mental health. 

Submission Requirements:

  • In the table, write the 3 criteria above and respond to them.
  • The table is to be clear and concise
  • The table is to be complete and thorough. It should include all items indicated in the assignment.
  • Incorporate at least 3 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. 

Mod.2IN DiscussionReply

You should respond to both discussions separately–with constructive literature material- extending, refuting/correcting, or adding additional nuance to their posts. 

Minimum 150 words each reply. 

Incorporate a minimum of 2 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. Journal articles should be referenced according to the current APA style (the online library has an abbreviated version of the APA Manual).

Discussion 1:

Advocacy is a cornerstone of nursing practice, particularly in concierge medicine, where the emphasis is on personalized, patient-centered care. Concierge nurses have the unique ability to form strong relationships with patients, allowing them to advocate for preventive care, holistic wellness, and improved coordination of services. Unlike traditional healthcare settings, where time constraints often limit patient interactions, concierge medicine provides nurses with more opportunities to advocate for optimal patient outcomes. Below are two key examples of advocacy in concierge nursing practice.

Advocacy for Preventive and Holistic Care

In my nursing practice (concierge medicine), I advocate for preventive care by emphasizing lifestyle modifications, early screenings, and wellness programs tailored to the individual patient’s needs. Unlike traditional healthcare settings where appointments may be rushed, concierge nurses can educate and empower patients on preventive strategies. For example, I may notice that a patient has risk factors for cardiovascular disease but has not undergone recent lipid screenings. By advocating for early intervention, I collaborate with the physician to order the necessary tests, provide dietary and exercise counseling, and follow up with the patient regularly to ensure adherence to lifestyle changes. Research supports that proactive, patient-centered care models improve health outcomes and reduce hospitalizations (Klein et al., 2022).

Advocacy for Care Coordination and Patient Autonomy

Concierge medicine often caters to patients with complex, chronic conditions who require seamless coordination across multiple specialists. In this setting, I act as a patient advocate by ensuring that referrals, follow-ups, and treatments are streamlined and that patients fully understand their options. For instance, if a patient with chronic Lyme disease expresses frustration over conflicting treatment recommendations from different specialists, I can step in as an advocate by facilitating collaborative discussions among providers. I would ensure that the patient’s preferences and concerns are addressed, helping them make informed decisions about their care. Studies indicate that strong care coordination improves patient satisfaction and reduces medical errors (Huang et al., 2023).

Conclusion

In concierge medicine, nurses, like me, play an essential role in advocating for preventive health strategies and coordinating patient-centered care. By focusing on education, early intervention, and seamless communication, I can help enhance patient outcomes and foster trust and empowerment in healthcare relationships.

References

Klein, S., Hostetter, M., & McCarthy, D. (2022). The role of concierge medicine in improving patient outcomes: A review of personalized healthcare models. Journal of Patient-Centered Care, 17(4), 245-259.

Huang, B., Patel, S., & Singh, R. (2023). Advancing care coordination in personalized medicine: A nursing perspective. International Journal of Integrated Healthcare, 28(1), 15-32.

Discussion 2:

Nursing is one of the most trusted and respected professions of today due to various attributes including advocacy. Advocacy is characterized by acting to endorse a

cause, however advocacy in nursing is far more than that. Patients frequently look to nurses as advocates to assist them in benefit to their health and support to assert their

rights when developing and carrying out a plan of care. Nurses must aim for balance when providing patient care and practice advocacy keeping in mind the four primary

ethical tenets which are beneficence, justice, autonomy, and non-maleficence (Haddad, 2023). Advocacy may vary depending on the setting of practice, for instance, a

nurse in community health would advocate for the general wellbeing of a community (Mason, Gardner, Outlaw & O’Grady, 2016).

Advocacy   

     As an intensive care unit (ICU) nurse, many of the patient’s we treat may have severe limitations to communicate or express their wishes. In the ICU and other clinical

settings, patients are typically at risk for complications or injury due to the complexity of their disease process or due to their lack of knowledge about the seriousness of

their sickness (Nsiah, Siakwa & Ninnoni, 2019). Two essential ways of advocacy that I’ve seen in such practice to achieve optimal patient outcomes are, promoting patient

safety and encouraging effective communication. For instance, a patient that is admitted with a significantly large abdominal aortic aneurysm (AAA) that is refusing

surgical intervention must be closely monitored with blood pressure and heart rate parameters as well as fall preventions to avoid a sudden rupture of such; we can all also

see in this scenario that the patient practiced autonomy by making their decision of not proceeding with surgical intervention. Nurses serve as liaison between

interdisciplinary teams, patients, family, and other resources which is achieved through effective communication due to closeness of treatment between the nurse and the

patient. Effective communication in nursing is beneficial from preventative medicine to end-of-life care. The nurse may sometimes have to be the voice of the patient

while advocating for them and may be required to discuss any requirements the patient may have with the physician to consult other providers or resources (Nsiah, Siakwa

& Ninnoni, 2019). Effective communication is necessary not only between providers and resources, but it must also be present amongst family members and loved ones.

Family must be included, updated, and educated on the plan of care for informed decisions to be made. Advocacy for achieving effective communication and safety is

intertwined, as detailed information is efficiently provided to patient’s, providers, and loved ones, awareness of safety grows which in turn prevents complications.

Conclusion

Patient advocacy reduces the tasks of nurses, establishes that patients receive quality treatment, leads to faster recoveries, and reduces the strain on the healthcare system.

Encouraging patient safety and effective communication are positive inputs to aim for optimal patient, it is every nurses responsibility to be an advocate for every patient.

References 

Haddad, L. M. (2023, August 14). Nursing ethical considerations. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK526054/

Mason, D. J., Gardner, D. B., Outlaw, F. H., & O’Grady, E. T. (2016a). Policy & Politics in Nursing and Health Care. Elsevier.

Nsiah, C., Siakwa, M., & Ninnoni, J. P. K. (2019). Registered Nurses’ description of patient advocacy in the clinical setting. Nursing open6(3), 1124–1132.                                https://doi.org/10.1002/nop2.307

WEEK5DISC

  • Review the Resources and reflect on the mission of state/regional boards of nursing as the protection of the public through the regulation of nursing practice.

NUR 507 Clinical Discussion 2

Describe your clinical experience for this week.

  • Did you face any challenges, any success? If so, what were they?
  • Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and at least 3 possible differential diagnosis with rationales.
  • Mention the health promotion intervention for this patient.
  • What did you learn from this week’s clinical experience that can beneficial for you as an advanced practice nurse?
  • Support your plan of care with the current peer-reviewed research guideline.

Submission Instructions:

  • Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.

NUR 507 Lecture Discussion 2

discuss the following:

List strategies that might be used by a pediatric primary care provider to incorporate developmental anticipatory guidance into the following sick visits:

  1. An 18-month-old with an acute upper respiratory infection
  2. A 4-year-old with stool withholding and constipation
  3. A 9-year-old with chronic headaches
  4. A 15-year-old with dysmenorrhea.

Submission Instructions:

  • Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.

Disseminate Results with Classmates

 Discuss your proposal change project with your classmates, including brief information about the process, the results obtained, and your experience completing it. 

Instructions 

Contribute a minimum of 500 words for your initial post. It should include at least 2 academic sources, formatted and cited in APA.

Pay attention to grammar rules (spelling and syntax).

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